| NPI | 1346534393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 8565462-3902) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MT BBH-LMFT-LIC-12233) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2026-06-18 |